| NPI | 1922121573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY WAITE Office Manager 312-642-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036043395) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: IL 036043395) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |